Current and Future Challenges in Diabetes Prevention, Diagnosis

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State DPCP Funding A Legislative Priority Ivan
K. Lanier Veronica DeLaGarza Stephen Habbe
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OUR PRIORITIES

• Increase federal and state funding for diabetes
  research and programs

Improve insurance coverage and health care for
people with diabetes
End discrimination against people with diabetes
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Federal Funding for Research and Diabetes
Prevention Programs

• A greater federal commitment to diabetes research
  and prevention funding is critical in the fight
  against diabetes. As such, the American Diabetes
  Association continues to lobby Congress and the
  Administration to increase funding for diabetes
  research at the National Institutes of Health
  (NIH) and diabetes treatment and prevention at
  the Centers for Disease Control and Prevention
  (CDC).

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Federal Funding for Research and Diabetes
Prevention Programs

• ADA strongly urges the 110th Congress to pass a
  new budget that increases NIH diabetes research
  funding by 8 percent (148.4 million) and CDC
  diabetes prevention and treatment efforts by
  20.8 million - one dollar for every American
  with diabetes. While these are difficult demands
  in the current fiscal environment, where
  non-defense dollars are scarce, these numbers
  reflect the diabetes burden in the United States.

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Federal Funding for Research and Diabetes
Prevention Programs

• On February 5, 2007, the Bush Administration
  announced its budget proposal for Fiscal Year
  2008. Rather than heighten the federal investment
  in diabetes research and prevention, the
  Administrations budget would provide a
  less-than-1 percent increase for diabetes
  research at NIH and flatten the CDCs diabetes
  prevention budget. Federal diabetes funding has
  not been increased in four years, where in the
  same time frame diabetes prevalence has increased
  by nearly 30 percent.

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Federal Funding for Research and Diabetes
Prevention Programs

• The CDCs Division of Diabetes Translation (DDT)
  leads the governments effort to provide
  comprehensive prevention and treatment programs
  in communities throughout the United States. DDT
  runs state-based Diabetes Prevention and Control
  Programs, which take medical research such as
  that sponsored by NIH and translates it into
  practices and programs that can be used in local
  communities. These programs help those currently
  suffering from diabetes better control and manage
  the disease and also help those at risk for
  diabetes prevent or delay its onset.
  Unfortunately, current funding levels only allow
  the Division of Diabetes Translation to provide
  full support for 28 states.

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States Are Not Funded Equally
ME
WA
MT
ND
VT
MN
NH
OR
NY
MA
WI
ID
SD
MI
CT
R I
WY
PA
NJ
IA
NE
OH
MD
DE
IN
IL
NV
wv
UT
VA
CA
CO
KY
KS
MO
NC
TN
OK
SC
AR
AZ
NM
GA
AL
MS
LA
TX
AK
FL
HI
Basic Implementation Diabetes Prevention
Control Programs Capacity Building Diabetes
Prevention Control Programs
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STATE GOVERNMENT AFFAIRS INITIATIVES

• Expand health coverage for diabetes in state
  plans and oppose efforts to eliminate or reduce
  diabetes coverage
• Preserve Medicaid benefits and oppose proposals
  to reduce benefits or eligibility
• Increase state funding for Diabetes Prevention
  and Control Programs
• Safe at School Bills Barriers for Students with
  Diabetes
• Enhance stem cell research and funding
• American Diabetes Association, American Cancer
  Society and American Heart Associations
  collaboration on physical education in schools

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Diabetes Prevention and Control Program

• Currently all states and territories receive
  federal funding for the DPCP.
• There are two funding levels capacity and basic
  implementation. Capacity-building awards average
  of 270,000 to state health departments. These
  diabetes prevention and control programs are
  involved in developing initial expertise,
  providing a focal point, defining the scope of
  the problem, identifying gaps in patient access
  and quality-of-care issues, identifying external
  supporters for diabetes control activities and
  limited intervention projects. Basic
  implementation awards average of 725,000 to
  state health departments.

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Diabetes Prevention and Control Program

• These diabetes prevention and control programs
  build on expertise in program, science, and
  policy areas to control and prevent diabetes,
  coordinate statewide efforts, expand systems to
  define and analyze the scope of the diabetes
  problem, improve access to diabetes care for all
  people and raise the quality of that care, use
  statewide public health projects to reduce
  diabetes-related problems, inform, educate, and
  empower external supporters to control and
  prevent diabetes. CDC funds do require
  non-federal matching funds at 1 non-federal for
  every 5 federal (capacity) and 1 non-federal
  for every 4 federal (basic). Even though the
  name was changed to include "prevention" focus
  and funding allocation remains diabetes awareness
  and prevention of diabetes complications.

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Diabetes Prevention and Control Program

• For approximately the last 9 years, Illinois has
  received basic implementation funding in the
  range of 900,000. The funds from CDC are the
  sole funding source. Matching funds are obtained
  through in-kind staff hours and/or donated
  materials from partners.

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State Based DPCP Grants

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State Based DPCP Grants

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FUNDING DIABETES CONTROL PROGRAMS

ADA encourages state legislators to increase
funding for the CDC Diabetes Prevention and
Control Programs in their state and to expand
their existing prevention and treatment
efforts. States deemed best able to use new
state resources to expand diabetes prevention and
control activities include Arkansas Californi
a Colorado Florida Idaho Kentucky New
Mexico New York Oklahoma Rhode
Island Texas Vermont Wisconsin
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Diabetes Prevention and Control Program

• The Association is advocating for increased
  funding for the CDC Diabetes Prevention and
  Control Programs in every state and the District
  of Columbia. While at the federal level the
  association is focused on protecting and
  increasing the amount Congress appropriates to
  the CDC for research and prevention, at the state
  level the Association is seeking additional
  funding from the states to further improve the
  infrastructure of theses state-wide programs
  whose mission is to prevent and control diabetes.
• Arizona On June 16 2006, at midnight, the last
  amendment of the night, the Appropriations
  Conference Committee Report was amended to
  include 1 million dollars for the state DPCP.
  The Governor signed this legislation on June 22.
• Michigan The Diabetes and Kidney line in the
  State Budget was increased by 48,400.00 over
  previous FY.
• New York ADA was successful in advocating for
  increasing the funding that is explicitly
  dedicated to the NY Diabetes Prevention and
  Control Program. Last year, 149,500 was
  provided. This year the budget contains
  1,150,500, an increase of 1,001,000.

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• NEW YORK

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New York Diabetes Prevention and Control Program

• Variety of Funding Sources (1.6m to 1.9m total)
• CDC
• State appropriation for the program
• MCH funds
• Prevention Block Grant
• Commissioners Priority Pool
• History of State Appropriation
• FY03 FY04 FY05 FY06
• 550,000 148,900 148,900 148,900

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Growing Prevalence and New York Times Series

• Scope of Diabetes in NY
• 1.1 million diagnosed adults and 400,000
  undiagnosed adults
• NYC estimates 1 in 8 adult city residents have
  diabetes
• NY Medicaid program covering nearly 300,000 with
  diabetes
• New York Times Series on Type 2 Diabetes in NYC
  (January, 2006)
• ADA Advocacy to Boost State Funding
• Information and meetings with Governors office
  and legislators
• Assembly sign-on letter with 28 members support
• Senator Marcellino took up the cause in the
  Senate
• ADA advocates weighed in with their legislators
  via e-mail
• Assembly and Senate both provide additional
  funding

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The Result

• Funding Timeline
• FY03 FY04 FY05 FY06 FY07
• 550,000 148,900 148,900 148,900 1,149,900
  
• How The Funds Were Spent
• 50,000 provided to each of 15 community
  coalitions for diabetes prevention. Coalition
  objectives include
• Capacity building/sustainability
• Primary prevention
• Secondary prevention
• Professional education
• Public awareness raising of diabetes risk factors
• Policy, environmental, and systems change

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• ARIZONA

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• NEW MEXICO